Krukenberg tumor, which can account for 30-40% of metastatic cancers to the ovaries, arises in the ovarian stroma and is usually metastatic from the gastrointestinal tract, especially from the stomach. The pathognomonic feature is the presence of signet ring cells, which may be arranged in acini or appear as individual cells. We experienced a Krukenberg tumor which was bilateral and associated with left ovarian dermoid cyst. This patient was treated for a primary gastric carcinoma(Stage II) about 3 years ago. After bilateral salpingoophorectomy, she received adjuvant chemotherapy. But, she died about fow months after operation.
Chemotherapy, Adjuvant ; Dermoid Cyst* ; Female ; Gastrointestinal Tract ; Humans ; Krukenberg Tumor* ; Ovary ; Stomach

The fractures of the distal femur are difficult to treat due to its severity of injuries and various complications. Recently, the complications including nonunion, delayed union and joint stiffness have decreased with development of new fixation device, technics and encouraging the early joint motion. We studied 50 cases of fractures treated at our hospital from January, 1980 to July, 1988 and the results obtained from this study were as follows:1. The age distribution was between 11 and 77 year-old, and the 3rd. 4th. decades were 64 % of total patients. 2. The most common cause of injuries was traffic accident(62%), and the open fractures were more common than the fractures of other reports(48%). 3. The types of fracture were unicondylar(21 cases), simple supracondylar(8), and intercondylar (21), according to Chiron's classification, and the intercondylar fractures were subdivided into type I (2 cases), type II A(6), type II B(10) and type III (3) by Neer's. 4. Among the 50 cases, the conservative treatments were done in 19 cases and the surgical one in 31 cases. The conservative treatments were done for undisplaced or minimal displsced fractures and the cases whose general conditions were so poor that operation were impossible. 5. In surgical treatments, the open reduction and the internal fixation(25 cases), the externsl fixation(4), the knee fusion(1) and the A-K amputation(1) were done. 6. The postoperative complications were joint stiffness(11 cases), malunion(3), delayed union(3) and infection(3). 7. The satisfactory results could be obtained by the open reduction and rigid internal fixation followed by early continous passive motion exercise of knee joint.
Age Distribution ; Classification ; Clinical Study ; Femur ; Fractures, Open ; Humans ; Joints ; Knee ; Knee Joint ; Postoperative Complications

No abstract available.
Ascites* ; Intussusception*

Congenital diaphragmatic eventration is an abnormal elevation of the diaphragm as a result of developmental failure of muscular fibers during the fetal period. Mediastinal shift to the contralateral side may cause significant compression of the affected chest contents resulting in compromised pulmonary function especially when bilaterally involved. The differentiation between congenital diaphragmatic eventration and diaphragmatic hemia is very difficult but eventration has a better perinatal outcome compared to diaphragmatic hernia. We report a case of congenital diaphragmatic eventration on left side with good perinatal outcome after plication in which the initial prenatal diagnosis of diaphragmatic hernia was made by prenatal ultrasonography.
Diaphragm ; Diaphragmatic Eventration* ; Hernia, Diaphragmatic* ; Prenatal Diagnosis ; Thorax ; Ultrasonography ; Ultrasonography, Prenatal

BACKGROUND: Nonimmune hydrops fetalis has become an important perinatal problem since it was first described in 1943. Although recent advances in antenatal ultrasound have made it possible to detect and manage nonimmune hydrops fetalis in early pregnancy, the perinatal mortality is still high. OBJECTIVE: To obtain clinically useful data regarding antenatal diagnosis, management, and perinatal outcomes of nonimmune hydrops fetalis, and to assist clinicians offer proper antepartum counseling and obstetric management which may be able to improve prognosis. Study design: We retrospectively reviewed 33 cases of nonimmune hydrops fetalis delivered in our hospital over a 4-year period. RESULTS: The antenatal diagnosis was possible by ultrasonography in all cases. Accumulation of fluid in fetal serous cavity and generalized skin edema were observed in all cases. A probable etiology was found in 23 (69.7%) cases through ultrasonography, various laboratory studies including fetal karyotyping, and autopsies. These were cardiovascular (4), respiratory (6), chromosomal (4), skeletal (1), and others (8). Despite extensive diagnostic studies, no definite etiology was found in 10 (30.3%) cases. Excluding the ten fetuses delivered after induced abortion, eight infants were born alive and six died in the neonatal period. The mortality rate was 91.3% (21/23). CONCLUSION: Nonimmune hydrops fetalis represents a very poor perinatal outcome. It is suggested that to improve the prognosis, various antenatal and postnatal approaches to find associated etiologic factors should be performed, and intensive perinatal cares are needed.
Abortion, Induced ; Autopsy ; Counseling ; Edema ; Female ; Fetus ; Humans ; Hydrops Fetalis* ; Infant ; Karyotyping ; Mortality ; Perinatal Mortality ; Pregnancy ; Prenatal Diagnosis ; Prognosis ; Retrospective Studies ; Skin ; Ultrasonography

PURPOSE: This study was to examine the effectiveness of exercise for bone mineral density (BMD). METHODS: Four investigators reviewed English articles from Pub Med and CINAHL, selecting randomized controlled trials on exercise programs for middle-aged and older women. Out of 25 studies identified, 14 that satisfied with the inclusion criteria were included in the meta-analysis. The quality of the studies was assessed using recognized methods and the effect size was calculated as a Hedges' g using Comprehensive Meta-analysis Version 2.0. Primary outcomes were changes in BMD at femoral neck, trochanter, and lumbar spine. Subgroup analysis included changes in BMD according to exercise style. RESULTS: Weight bearing exercise was effective (Q = 20.1, p > .05, ES = 0.32), and resistance exercise was effective in case of comparing to pre and post intervention (Q = 4.15, p = .98, ES = 0.14). At the femoral neck, 9 study groups were homogeneous and the experimental groups demonstrated a positive effect on BMD (Q = 19.5, p > .05, ES = 0.33). In contrast, marked heterogeneity (Q = 33.3, p < 0.01) was apparent in 7 study groups evaluating trochanter. CONCLUSION: These findings suggest that weight bearing is effective for BMD of the femoral neck, and is relevant to the non-pharmacological treatment of bone loss for middle-aged and older women.
Bone Density* ; Female ; Femur ; Femur Neck ; Humans ; Middle Aged ; Osteoporosis ; Population Characteristics ; Research Personnel ; Spine ; Weight-Bearing

OBJECTIVE: The goal of this study is to determine the efficacy of rapid karyotyping from fetal ascitic fluid. METHODS: In three cases of isolated fetal ascites diagnosed by prenatal ultrasonography, ultrasound guided fetal paracentesis and amniocentesis were performed and successfully obtained. Fetal karyotyping in each case at 29, 30 and 32 weeks gestation using modified lymphocyte culture method was conducted. RESULTS: The chromosomal analysis was successful within 72 hours and abnormalities were detected in two cases and revealed trisomy 21 in each case. Our study demonstrated that the majority distribution of white blood cells was lymphocytes which ranged from 2.1 * 10(6) cells/ml to 3.7 * 10(6) cells/ml and the cell density for culture was at least than 0.35 * 10(6) cells/ml. CONCLUSION: The use of ascitic fluid as a cell source to achieve rapid fetal karyotyping can be valuable when cordocenteis or amniocentesis would be technically more difficult, or when rapid result is required for planning of perinatal management at late second or third trimester gestational age.
Amniocentesis ; Ascites ; Ascitic Fluid* ; Cell Count ; Cytogenetics* ; Diagnosis* ; Down Syndrome ; Female ; Gestational Age ; Humans ; Karyotyping ; Leukocytes ; Lymphocytes ; Paracentesis ; Pregnancy ; Pregnancy Trimester, Third ; Ultrasonography ; Ultrasonography, Prenatal

PURPOSE: This study was undertaken to obtain better clinical insights and therapeutic approaches to the diverticular diseases of the colon by identifying the clinical characteristics of the right and left colonic diverticular diseases. METHODS: A retrospective analysis was made of 68 colonic diverticular patients treated between August of 1986 and July of 1997. Right colonic diverticular disease was present in 55 patients, left side disease in eight patients, and bilateral disease in five patients. According to the location of the colonic diverticular disease, various clinical parameters such as the nature of the diverticula, age and sex, diagnostic accuracy, and methods of treatment were assessed. RESULTS: The average age of 68 patients in this study was 50.94 years. Fifty two patients were male and sixteen were female. The disease was far more common in the right colon (80.9%) than the left colon (11.7%) and the right colonic diverticular disease was the most common source of confusion in diagnosis from acute appendicitis. Conservative management was tried in 30 of 35 patients above age 50 and obtained a good result without any complication. CONCLUSIONS: There has been a tendency toward increased incidence of annual colonic diverticular diseases in this study. The right colonic diverticular disease was far more common than the left side disease and the disease was more common in the male. In patients above age 50, initial conservative management is a reasonable approach, although early surgical exploration might be better in younger patients. Acute appendicitis should be ruled out before any treatment decision was made.
Appendicitis ; Colon ; Diagnosis ; Diverticulum ; Female ; Humans ; Incidence ; Male ; Retrospective Studies*

No abstract available.
Blister ; Humans ; Necrosis ; Rhabdomyolysis

No abstract available.
Hemorrhagic Fever with Renal Syndrome* ; Humans ; Proteinuria*